Question from Darlene: I’ve read several of your posts on Facebook and you seem to recommend moving from Supplement Plan G to Plan N all the time. Why do you advise people to do that when Plan N doesn’t cover Part B Excess charges? `

Answer: Very simply because no one ever gets billed for them and coverage for Excess Charges is in an antiquated benefit. 

Let me explain.

Only providers who don’t accept Medicare Assignment can bill for Excess Charges. Every health system and every full-service hospital in America accepts Medicare. Every physician, nurse practitioner, physician’s assistant, anesthesiologist, etc., who is employed by or works for a hospital or health system is under that umbrella contract with Medicare as well. 

In addition, any independent doctor who has hospital privileges, extremely rare today, also accepts Medicare Assignment. The fact is, any physician who does anything more than see patients for a routine office visit is contracted with Medicare. 

There are a few family or primary care doctors who don’t take Medicare, but they tend not to accept any insurance. And even if they decided to accept and bill Medicare, Excess Charges are capped, by law, at 15% over the Medicare’s contracted reimbursement schedule. So, we’re talking about $15 in Excess Charges for a visit to a family physician and maybe $20 to $30 for a specialist. I’ve actually never known of a specialist other than a psychologist or chiropractor who doesn’t take Medicare Assignment. 

With that in mind, you’re never going to get any tests done at a facility or lab, or a surgery or procedure performed by a doctor, who doesn’t accept Medicare Assignment. You’re never going to be an inpatient at a hospital that doesn’t take Medicare. Ever. 

At The Health Insurance Store, we’ve enrolled over 10,000 clients in Plan N policies since it was introduced in 2010. Not once have we heard from a client who was billed for Excess Charges. 

Too many people choose Plan G when they initially go on Medicare and don’t move to N after G becomes expensive due to the fear of Excess Charges. The result is paying literally tens of thousands of dollars more in premiums for a completely antiquated and unnecessary benefit. 

Let’s do the math. Those who are 70 years old and have Plan G are paying around $200 per month on average. If that 70-year-old were to switch to N now, it would cost $115. If both Plan G and N have a 12% rate increase annually over the next five years, the person on Plan G will spend $7,405 more on premiums than if they had switched to N. In ten years, that number would balloon to over $20,000!

I can’t preach this enough. Those who can move from Plan G, or even more antiquated and expensive plans C and F, need to do that now! You DO NOT have to wait for the next Annual Enrollment Period. Moving from Supplement to Supplement can be done all year round. 

The only difference between Plan G and N is the two small co-pays involved: $20 for a physician’s office visit and $50 for a trip to the ER. The deductible is the same, the coverage is the same, and access to doctors and hospitals is the same. 

Don’t let fear of change cost you this kind of money. 

If you have questions or would like a quote, give the office a call at 724-603-3403 or email me personally, Aaron@GetYourBestPlan.com.